Much needed epidemiological information is lacking regarding the relationships between smoking and dental disease in the large and rapidly increasing population of older Americans. The increased size of this population will likely magnify the number of Americans experiencing pain and suffering and financial burden due to largely preventable dental disease. This epidemiological investigation of the oldest old will involve an analysis of data obtained from the Buck Center for Research in Aging's cross sectional survey "Health and Functioning in Marin" (1989-1992). The study population consists of 2,019 elderly subjects of both genders. Subjects were identified in the original survey by racial groups. Five hundred and four of the subjects were in the oldest old cohort (> 84 years of age). The hypotheses to be tested are: a) smoking elders have a decreased state of dental health (painful or bleeding gums or tooth loss) compared to non-smoking elders, and b) a dose response exists between smoking habits and dental disease in the elderly. Relative risks and 95% confidence intervals will be constructed. Chi square tests for homogeneity and trends will be calculated. Stratification will test for confounding and effect modification. Logistic regression will be used to determine the model which best predicts the high risk group(s). This proposed study will provide information that will better.prepare the oldest old and those who provide their health care, to appreciate the relationship between dental disease and tobacco smoking. This should assist them in making wiser dental health maintenance decisions in the future. The assessment of dental disease in the elderly will help guide the development of a more comprehensive state wide assessment of the dental consequences of smoking for the elderly.